Hyperuricemia Clinical Presentation

Updated: Jul 01, 2022
  • Author: James W Lohr, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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In patients with hyperuricemia, the history involves determining whether the patient is symptomatic or asymptomatic and identifying causative etiologies and comorbid conditions.

Symptoms are those of gout and nephrolithiasis, as follows:

  • Gout typically manifests as an acute monoarthritis, most commonly in the great toe and less frequently in the tarsal joint, knee, and other joints.

  • Uric acid nephrolithiasis may manifest as hematuria; pain in the flank, abdomen, or inguinal region; and/or nausea and vomiting


Physical Examination

Patients are usually asymptomatic, and no specific physical findings are recognized. Symptomatic presentations may include the following:

  • In acute gouty arthritis, the affected joint is typically warm, erythematous, swollen, and exquisitely painful

  • Patients with chronic gouty arthritis may develop tophi in the helix or antihelix of the ear, along the ulnar surface of the forearm, in the olecranon bursa, or in other tissues

  • In uric acid nephrolithiasis, patients may present with abdominal or flank tenderness